Dale Van Demark on Medicare

Private Investors and Digital Health Attracting OIG Attention: General Compliance Program Guidance to Watch

On November 6, 2023, the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) published the General Compliance Program Guidance (GCPG) as a revised reference guide for the healthcare compliance...more

12/19/2023 / Centers for Medicare & Medicaid Services (CMS) , Compliance , Department of Health and Human Services (HHS) , Digital Health , False Claims Act (FCA) , Healthcare , Incentives , Investors , Medicare , OIG , Private Investment Funds , REIT , Shareholders , Transparency

Trending in Telehealth: July 11 – 17, 2023

Trending in Telehealth is a new series from the McDermott digital health team in which we highlight state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies,...more

7/21/2023 / Digital Health , Healthcare , Legislative Agendas , Medicaid , Medicare , New Legislation , Pharmaceutical Industry , Proposed Legislation , Rulemaking Process , Technology Sector , Telehealth

McDermott Health 2023 Annual Report - Digital Health: 2022 Year in Review

Digital health is one of the fast-growing segments of the healthcare market, with patients, clinicians and regulators increasingly aligned behind the opportunities that digitization presents. Over the last three years,...more

3/21/2023 / Controlled Substances Act , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Department of Justice (DOJ) , Digital Health , Dobbs v. Jackson Women’s Health Organization , Healthcare Fraud , Medicare , New Legislation , New Regulations , OIG , Proposed Legislation , Proposed Regulation , Public Health Emergency , Roe v Wade , State and Local Government , State Legislatures , Telehealth , Telemedicine

Remote Monitoring Services Under Review: Update on Potential Medicare Coverage Policies

A recent multijurisdictional contractor advisory committee (CAC) meeting held by six of the seven Medicare Administrative Contractors (MACs) gave stakeholders an initial opportunity to provide feedback on the strength of...more

3/6/2023 / Comment Period , Deadlines , Health Care Providers , Medicare , Medicare Administrative Contractors (MAC) , Physicians , Stakeholder Engagement , Subject Matter Experts (SMEs) , Technology Sector , Telehealth , Telemedicine

Remote Monitoring Services Under Review: Medicare Coverage Policies May Be Coming

Six of the seven Medicare Administrative Contractors (MACs) are scheduled to jointly host a multijurisdictional contractor advisory committee (CAC) meeting on February 28, 2023. This CAC panel meeting will allow the MACs to...more

1/27/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Insurance , Medical Devices , Medical Monitoring , Medicare , Medicare Administrative Contractors (MAC) , Policy Drafting , Public Meetings , Summary of Benefits and Coverage , Virtual Meetings

CMS Addresses Virtual Care Expansion in CY 2022 Medicare Physician Fee Schedule Proposal

On July 23, 2021, the Centers for Medicare & Medicaid Services (CMS) published its annual proposed changes to the Medicare Physician Fee Schedule (MPFS), which include several key telehealth and other virtual care-related...more

7/27/2021 / Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Health Care Providers , Medicare , Physician Fee Schedule , Physicians , Proposed Amendments , Telehealth

Avoiding Confusion Over State Licensing Laws as CMS Further Loosens Telemedicine Restrictions

The Centers for Medicare & Medicaid Services (CMS) continues to loosen the conditions for participation in Medicare, as well as specific reimbursement requirements, to ensure facilities and practitioners are able to practice...more

4/14/2020 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Licensing Rules , Medicaid , Medicare , Reimbursements , Telemedicine

Bipartisan Bill Relaxes Federal Telehealth Requirements in the Wake of COVID-19

On March 4, 2020, the House passed the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, a bipartisan bill to aid in COVID-19 preparedness and response. The bill includes, among other things,...more

3/6/2020 / Appropriations Bill , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Health Care Providers , Medicare , Pending Legislation , Telehealth

The Role of Telehealth in COVID-19 Response Efforts

As the number of confirmed COVID-19 cases in the United States grows, healthcare providers are stepping up their response planning. To combat the spread of COVID-19, the Centers for Disease Control and Prevention (CDC) urged...more

3/4/2020 / Centers for Disease Control and Prevention (CDC) , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Emergency Response , Health Care Providers , Infectious Diseases , Medicare , Telehealth

Dash to Digital Health? How the Regulatory Sprint to Coordinated Care Could Expand Access to Care

Certain long-standing laws, such as the civil monetary penalty provision prohibiting patient inducements, have hampered providers’ ability to fully leverage remote patient monitoring and other telehealth tools. Many...more

7/22/2019 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Digital Health , Health Care Providers , Medicare , Physician Medicare Reimbursements , Reimbursements , Telehealth , Telemedicine

2018 Digital Health Year in Review: Focus on Care Coordination and Reimbursement

In 2018, even more than in recent years, federal lawmakers and regulators continued the push toward modernizing the existing legal framework to support and encourage digital health adoption in the context of care coordination...more

The RUSH Act – Another Advancement in Telehealth Acceptance?

As previously noted in our Digital Health Mid-Year Review, 2018 has seen greater acceptance of telemedicine within the Medicare program. Both regulatory and statutory changes have expanded reimbursement opportunities and,...more

10/31/2018 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Hospitals , Medicare , Telehealth , Telemedicine

Mid-Year Digital Health Report: Focus on Medicare - July 2018

Where Things Stood - Understanding the impact of what we have seen so far this year first requires an understanding of where we were at the end of 2017, with respect to both Medicare reimbursement and provider adoption of...more

7/31/2018 / Bipartisan Budget Act , Centers for Medicare & Medicaid Services (CMS) , Digital Health , Hospitals , Medicare , Physician Fee Schedule

More Federal Legislation Aimed at Expanding Medicare Coverage of Telehealth Services

Late last month, Senator Cory Gardner (R-CO) and Senator Gary Peters (D-MI) introduced Senate Bill 787, the Telehealth Innovation and Improvement Act (Telehealth Improvement Act), which is focused on expanding Medicare’s...more

4/12/2017 / 21st Century Cures Act , CMMI , Health Care Providers , Medicaid , Medicare , Telehealth

21st Century Cures: A Closer Look

On December 7, 2016, the US Congress enacted the 21st Century Cures Act, substantial legislation intended to accelerate “discovery, development and delivery” of medical therapies by encouraging biomedical research investment,...more

21st Century Cures: Required Exploration of Telehealth Solutions

President Obama signed the 21st Century Cures Act on December 13, 2016. The act encourages biomedical research investment and facilitates innovation review and approval processes, but also serves as a vehicle for a wide...more

12/14/2016 / 21st Century Cures Initiative , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare , Medicare , MedPAC , Telehealth

Bipartisan Legislation Proposes Telehealth Solutions for Effective Chronic Disease Management

Collaborative efforts between congressional offices and various health care stakeholders, as well as the feedback provided in response to the Bipartisan CHRONIC Care Working Group Policy Options Document released in December...more

11/29/2016 / ACOs , Bipartisan Agreement , Medicare , Medicare Advantage , Telehealth

CMS Proposes Expansion of Telehealth Services Eligible for Medicare Reimbursement

Summary - The Centers for Medicare and Medicaid Services (CMS) released its CY2017 Physician Fee Schedule Proposed Rule on July 17 - after receiving requests from various stakeholders to add telehealth services as...more

8/3/2016 / Centers for Medicare & Medicaid Services (CMS) , Medicare , Physician Fee Schedule , Physician Medicare Reimbursements , Telehealth

Integration of Technology Into Health Care Delivery

The integration of technology into health care delivery is exploding throughout the health industry landscape. Commentators speculating on the implications of the information revolution’s penetration of the health care...more

7/20/2016 / Centers for Medicare & Medicaid Services (CMS) , Electronic Communications , Health Care Providers , Information Technology , Investment Opportunities , Medicaid , Medicare , Telehealth , Telemedicine

Managing the Transition to Transformation: Changing the Dynamic: How Alternative Payment Systems Are Changing the Strategic Goals...

Introduction - The transition of the US health care payment system from fee-for-service (FFS) to alternative value-based, budget-based, episode or procedure-based (e.g., bundled) and/or population-based payment models...more

7/20/2016 / Alternative Payment Models (APM) , Fee-for-Service , Health Care Providers , Hospitals , Medicare , Medicare Access and CHIP Reauthorization (MACRA) , Payment Systems

Digital Health: An Improving Environment for Investors

The integration of technology into health care delivery is exploding throughout the health industry landscape. Commentators speculating on the implications of the information revolution’s penetration of the health care...more

7/12/2016 / ACOs , Affordable Care Act , Big Data , Business Model , Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Health Information Technologies , Investment Opportunities , Medicaid , Medicare , Medicare Access and CHIP Reauthorization (MACRA) , Mobile Medical Applications , Telehealth , Telemedicine , Value-Based Payments

Managing the Transition to Transformation: Is Your Organization Ready for the Shift to Alternative and Quality-Based Payment...

For many decades, at least since the passage of the Health Maintenance Organization Act of 1973, there have been reform efforts focused on moving the United States health care system away from fee-for-service (FFS)...more

6/23/2016 / Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Fee-for-Service , Health Care Providers , Medicare , Medicare Access and CHIP Reauthorization (MACRA) , MIPS , Provider Payments

Significant Telehealth Expansion Proposed in Bipartisan Senate Bill

Earlier this month, a bipartisan group, led by U.S. Senator Brian Schatz (D-Hawaii), introduced a bill in the Senate focused on promoting cost savings and quality care under the Medicare program through the use of telehealth...more

2/29/2016 / Bipartisan Agreement , Department of Health and Human Services (HHS) , Hospitals , Medicare , Medicare Advantage , Native American Issues , Physician Medicare Reimbursements , Telehealth

Senate Finance Committee Considering Telehealth Options to Improve Care and Lower Costs

On December 18, 2015, the United States Senate Committee on Finance (the Committee) released a Bipartisan Chronic Care Working Group Policy Options Document), which outlines approaches under consideration to improve the care...more

1/6/2016 / ACOs , Beneficiaries , Medicare , Medicare Advantage , Senate Finance Committee , Telehealth

Dale Van Demark

McDermott Will & Emery

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